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Active Surveillance for Localized Prostate Cancer by Laurence Klotz Pdf
This fully updated and revised new edition provides a comprehensive, state-of-the art review of this field, and will serve as a valuable resource for clinicians, surgeons and researchers with an interest in prostate cancer. The book reviews new data about molecular characteristics of the disease, profiles the new grading system for prostate cancer introduced in 2015, and provides new perspectives about imaging of prostate cancer, as well as the role of targeted biopsies. The text summarizes the role of biomarkers and MRI in patient selection and management and details the world wide results of active surveillance. Specific chapters address communication and ethical issues, QOL outcomes, economic aspects, and psycho-social aspects of surveillance. The role of focal therapy for low risk disease is summarized, and the data supporting preventive interventions during surveillance reviewed. This text will serve as a very useful resource for physicians and researchers dealing with, and interested in this common malignancy, as it provides a concise yet comprehensive summary of the current status of the field that will help guide patient management and stimulate investigative efforts.
Active Surveillance for Localized Prostate Cancer by Laurence Klotz Pdf
Active Surveillance for Localized Prostate Cancer: A New Paradigm for Clinical Management will serve as a useful resource for physicians dealing with, and interested in, this complex and evolving branch of prostate cancer management. The book will also be of interest to scientifically literate patients and their families. The volume provides an introduction to the concept of active surveillance in oncology in general and prostate cancer specifically. The primary focus is to provide a comprehensive guide to the management of patients on surveillance. The volume covers the many complexities and nuances to this approach including, patient selection, risk assessment, how to overcome 'cancer hysteria' when counseling patients, identifying appropriate triggers for intervention, use of PSA kinetics and MR imaging information, technique and frequency of biopsies, secondary prevention interventions, and the relative roles of surveillance and focal therapy.
The Prostate Cancer Dilemma by Nelson N. Stone,E. David Crawford Pdf
This text provides a comprehensive, state-of-the art review of this field, and will serve as a valuable resource for clinicians, surgeons and researchers with an interest in early prostate cancer. The book reviews new data about genetic markers, transperineal mapping biopsy and mpMRI, how to apply each of these technologies in patients with elevated PSA, when a prior prostate biopsy performed by the standard TRUS method is negative and in cases where low risk disease is already diagnosed, how to differentiate those men who might harbor more aggressive disease from those who do not. Over 75% of newly diagnosed prostate cancer meets the criteria for low risk disease which has created a dilemma for both patients and clinicians. Active surveillance programs have been initiated and are reviewed. How the new technologies impact surveillance programs is addressed. Clinical stage designation is updated and a new intra-prostatic staging system is discussed. Prostate biopsy techniques utilizing transrectal ultrasound, transperineal mapping, elastography and mpMRI are compared. Finally, utilization of this new technology in the application of focal therapy is reviewed. The Prostate Cancer Dilemma will serve as a very useful resource for physicians and researchers dealing with, and interested in this challenging malignancy. Chapters are written by experts in their fields and include the most up to date scientific and clinical information as well as links to procedural video content.
Technical Aspects of Focal Therapy in Localized Prostate Cancer by Eric Barret,Matthieu Durand Pdf
Focal therapy is a promising option for selected patients who have localized low or intermediate-risk prostate cancer, providing a compelling alternative between active surveillance and radical therapies by targeting the index lesion and preserving as much tissue as possible. Numerous cohort studies have already investigated multiple focal techniques, such as cryotherapy, high-intensity focused ultrasound, brachytherapy, photodynamic therapy, laser therapy, irreversible electroporation and cyberknife methods, all of which have demonstrated positive oncological outcomes with 70 to 90 % negative follow-up biopsy. These various ablative techniques have produced only minor side-effects concerning urinary function, a low rate of erectile dysfunction, and have demonstrated a limited rectal toxicity. As a result, the primary end-point has now shifted and a new strategy needs to be established for patient follow-up and for defining treatment failure. Written by international experts in the field, this book is mainly focused on new techniques, all of which are amply illustrated. Technical Aspects of Focal Therapy in Localized Prostate Cancer will be of great practical value to all urologists and oncologists.
Management of Prostate Cancer by Michel Bolla,Hendrik van Poppel Pdf
This book, now in an extensively revised second edition, provides an exhaustive review of the state of the art in the management of prostate cancer, from screening to treatment, with emphasis on a multidisciplinary approach. The editors are very excited about the outstanding new or updated contributions from the different expert authors. The opening chapters address basic aspects including epidemiology, pathology, biology, genetics, and chemoprevention. The role of individual and mass screening is carefully appraised, and extensive attention is devoted to diagnosis and clinical work-up by means of recently implemented investigations such as multiparametric MRI and choline PET-CT. The use of active surveillance is examined in detail. Subsequent chapters discuss the different therapies that may be employed: open and minimally invasive, including robot-assisted, radical prostatectomy, the various forms of radiation treatment, high-intensity focused ultrasound, cryotherapy, hormonal manipulations, chemotherapy, targeted therapies, and immunotherapy. Up-to-date results from practice-changing phase III randomized clinical trials are included and special insights are provided into the interpretation of results and the patient’s perspective.
Management of Prostate Cancer by Michel Bolla,Hendrik van Poppel Pdf
This book provides an exhaustive review of the current state of the art in the management of prostate cancer, from screening to treatment. A particular feature is the emphasis placed on the value of a multidisciplinary approach. The opening chapters address basic aspects including epidemiology, biology, and chemoprevention. The role of individual and mass screening is carefully appraised, and diagnosis, clinical work-up, and the role of active surveillance are discussed in detail. Subsequent chapters are devoted to each of the therapies that may be employed, including open and robotic laparoscopic radical prostatectomy, the various forms of radiation therapy, high-intensity focused ultrasound, cryotherapy, hormonal therapy, and targeted therapies and vaccination. Up-to-date data from clinical trials are included. The editors are members of the EORTC who have coordinated phase III EORTC trials and have worldwide reputations.
Multidisciplinary Management of Prostate Cancer by Vincenzo Gentile,Valeria Panebianco,Alessandro Sciarra Pdf
Prostate cancer is the most common neoplasm in men and its management is very complex, in terms of both diagnosis and treatment. In recent years the value of multidisciplinary management within a prostate cancer unit has been increasingly recognized. Such a multidisciplinary approach within a specialized unit involves a variety of specialists, including urologists, oncologists, radiotherapists, radiologists and pathologists. This book describes in detail the advantages of multidisciplinary management of prostate cancer. It opens by explaining the nature of the required multidisciplinary team and the potential benefits of the prostate cancer unit as a structure for the delivery of specialist multidisciplinary care. Epidemiological aspects favoring multidisciplinary management are described and each element of care within the context of the prostate cancer unit is then discussed; also has been described the role of advanced imaging (Multiparametric MRI) in the management of PCa. Early diagnosis, risk classification, treatment decision making, surgery, radiotherapy, medical therapies and health care support are all fully considered. This book will be informative and enlightening for all who are involved in the management of patients with prostate cancer.
Author : Ashutosh K. Tewari,Peter Whelan,John D. Graham Publisher : John Wiley & Sons Page : 395 pages File Size : 42,6 Mb Release : 2013-12-23 Category : Medical ISBN : 9781118347393
Prostate Cancer by Ashutosh K. Tewari,Peter Whelan,John D. Graham Pdf
Do you manage patients with prostate cancer? Could you use an expert guide examining all possible management options? Prostate Cancer: diagnosis and clinical management providesurologists and oncologists of all levels with up-to-date, evidence-based guidance to the diagnosis, treatment and clinical management of a disease which accounts for a quarter of all cancers affecting men. Designed to be as practical and accessible as possible, leading experts discuss key issues in prostate cancer management and examine how to deliver best practice in the clinical care of their patients. Topics covered include: What must be considered when counseling newly-diagnosed cancer patients Radical surgery options for prostate cancer Novel therapies for localized prostate cancer How should metastatic prostate cancer be diagnostic and managed What are the best methods of administering end of life care for the patient Brought to you by a highly experienced editor team, and containing key points, management algorithms, practice tips and the latest AUA and EAU clinical guidelines, this is the ideal consultation tool for doctors both on the wards and in the office.
Adenocarcinoma of the Prostate by Andrew W. Bruce,John Trachtenberg Pdf
Carcinoma of the prostate increasingly dominates the attention of urologists for both scientific and clinical reasons. The search for an explanation and the prediction of the variable behaviour of the malignant prostatic cell continues unabated. The search for more precise tumour staging and more effective treatment is equally vigorous. Editors Andrew Bruce and John Trachtenberg have assembled acknowledged leaders in prostate cancer to present those areas of direct interest to the clinician. There are a number of other topics that might have been considered but most of these, such as experimental tumour models or biochemical factors affecting cell growth, still lack immediate application for the clinician. Carcinoma of the prostate continues to have its highest incidence in the western world, and the difference in comparison with the incidence in the Far East appears to be real and not masked by diagnostic or other factors. A number of other epidemiological aspects need careful analysis: Is the incidence increasing? Is the survival improving? Is the prognosis worse in the younger patient? Epidemiological data are easily misused and misinterpreted so that a precise analysis of the known facts makes an important opening chapter to this book.
The Gleason system is the most important prognostic marker of prostate cancer that is critical to patient management and drives therapies across all disciplines dealing with prostate cancer. In addition to an extensive number of photographs, this book discusses in detail clinically related issues that are crucial for the urologist, radiotherapist, and oncologists to know, such as predicting upgrading and downgrading from needle biopsy to radical prostatectomy, risk of Gleason grading change over time, significance of tertiary grade patterns, and prognosis and implications related to various Gleason scores and different therapies. Images that were particularly difficult for contributing pathologists sent in for consultation are used in addition to classic examples, as these cases are the most informative in showing the difficulties with Gleason grading.
Fast Facts: Prostate Cancer by R.S. Kirby,M.I. Patel,D.M.C. Poon Pdf
This is the tenth edition of this Fast Facts handbook since the first was published in 1996 – the many iterations are testament to the rapid changes in the field and steadily improving outlook for patients. This new edition introduces the Gleason grade grouping (Chapter 1), which has important prognostic value, and nomograms that are used to evaluate risk (Chapter 3). Our understanding of the genetics and underlying pathogenesis of prostate cancer is growing apace, leading to the identification of germline mutations and the development of genomic tests to help identify and direct therapy for those at greatest risk of developing clinically significant disease. They also provide reassurance for those patients who have opted for active surveillance (Chapters 3 and 5). Imaging techniques are also improving rapidly, particularly multiparametric MRI (Chapter 4). As this book is concise, fully up to date and evidence based, we believe it is an ideal resource for those general urologists, primary care providers, specialist nurses, trainees and allied healthcare professionals who want to get quickly up to speed in this fast-moving and ever-expanding field. Contents: • Epidemiology and pathophysiology • Diet, lifestyle and chemoprevention • Screening and early detection • Diagnosis, staging and prognostic indicators • Management of clinically localized disease • Managing recurrence after initial therapy • Managing metastatic hormone-sensitive prostate cancer • Management of castrate-resistant prostate cancer • Survivorship and management of treatment-related side effects and complications
Reading MRI of the Prostate by Ananya Panda,Vikas Gulani,Lee Ponsky Pdf
This book provides a concise guide to prostate cancer imaging. Beginning with normal MR anatomy, the book details the various components of a typical mpMRI protocol and discusses MR interpretation and reporting under PI-RADS version 2 guidelines. MR appearances of atypical locations of prostate cancer, common tumor mimics, MR-guided biopsy strategies, and the role of active surveillance are also covered. Reading MRI of the Prostate aims to help urologists and radiologists understand the evaluation and interpretation of prostate MRIs.
U. S. Department of Health and Human Services,Agency for Healthcare Research and Quality
Author : U. S. Department of Health and Human Services,Agency for Healthcare Research and Quality Publisher : Createspace Independent Pub Page : 108 pages File Size : 48,9 Mb Release : 2013-05-14 Category : Medical ISBN : 1484974204
Future Research Needs for Comparative Effectiveness of Treatments of Localized Prostate Cancer by U. S. Department of Health and Human Services,Agency for Healthcare Research and Quality Pdf
An estimated 1.8 million men living in the United States have a diagnosis of prostate cancer, with about 218,890 newly diagnosed men each year. Approximately 90 percent of men with prostate cancer have disease considered confined to the prostate gland (i.e., clinically localized disease). If left untreated, frequently men die with, rather than from, prostate cancer. Largely because of widespread prostate-specific antigen (PSA) testing, the lifetime risk of prostate cancer diagnosis in the United States has nearly doubled to 20 percent, while the risk of dying of prostate cancer has remained at approximately 3 percent. Therefore, considerable over detection and treatment may exist. Moreover, the treatment of localized prostate cancer is associated with substantial adverse effects. The primary goal of treatment is to target those men most likely to need intervention to prevent prostate cancer death and disability, while minimizing intervention-related complications. Common treatments include watchful waiting (active surveillance), surgery to remove the prostate gland (i.e., radical prostatectomy), radiotherapy (e.g., external-beam radiation or brachytherapy), freezing the prostate (i.e., cryotherapy), and androgen-deprivation therapy (ADT). All treatments for prostate cancer have risks of complications, although their frequency and severity may vary. Common adverse events include urinary, bowel, and sexual dysfunction. The vast majority of prostate cancers currently detected in the United States are asymptomatic, clinically localized, and found on routine PSA testing. PSA testing detects more tumors, at an earlier stage, with a smaller volume within each stage, and at an earlier period in a man's life than nonscreen-detected tumors. The clinical significance, natural history, and comparative effectiveness of treatments in PSA-detected cancers are not known but likely differ from those detected and treated in the pre-PSA era (before the late 1980s to early 1990s). The objective of this project is to pilot an approach for developing future research priorities and suggesting specific projects to address evidence gaps. From the results of this and comparable pilot projects conducted by other Agency for Healthcare Research and Quality (AHRQ) Evidence-based Practice Centers (EPCs), AHRQ will identify generalizable strategies and lessons learned. The topic of this pilot project, the comparative effectiveness of treatments for localized prostate cancer, was selected because of its importance. The Minnesota EPC completed a comparative effectiveness review (CER) on this topic in 2008 for AHRQ. This pilot project amends the list of recommendations from that report and creates prioritized lists of research gaps and proposed research studies. Subsequently, management strategies for local prostate cancer were in the first quartile of the Institute of Medicine's 100 initial priority topics for comparative effectiveness research: Compare the effectiveness of management strategies for localized prostate cancer (e.g., active surveillance, radical prostatectomy [conventional, robotic, and laparoscopic], and radiotherapy [conformal, brachytherapy, proton beam, and intensity-modulated radiotherapy]) on survival, recurrence, side effects, quality of life, and costs.
Institute of Medicine,Board on Health Care Services,National Cancer Policy Forum
Author : Institute of Medicine,Board on Health Care Services,National Cancer Policy Forum Publisher : National Academies Press Page : 126 pages File Size : 40,7 Mb Release : 2012-06-12 Category : Medical ISBN : 9780309253369
The Role of Obesity in Cancer Survival and Recurrence by Institute of Medicine,Board on Health Care Services,National Cancer Policy Forum Pdf
Recent research suggests that obesity and excess weight can play a prominent role in the incidence and progression of various cancers. Obesity results from an energy imbalance - that is, energy intake that is higher than energy expenditure - could also influence the growth of cancers. Recognizing the impact that current findings on obesity and cancer could have on future cancer prevention and care, the National Cancer policy Forum (NCPF) of the Institute of Medicine (IOM) help a 2-day workshop on "The Role of Obesity in Cancer Survival and Recurrence," in Washington, DC, on October 31 and November 1, 2011. The Role of Obesity in Cancer Survival and Recurrence: Workshop Summary reviews each presenter's latest clinical evidence on the obesity-cancer link and the molecular mechanisms that might explain that link. Clinicians, researchers, cancer survivors, and policy makers also discussed potential interventions to counter the effects of obesity on cancer, and research and policy measures needed to stem the rising tide of cancer mortality predicted by an increasingly overweight and older population worldwide. The Role of Obesity in Cancer Survival and Recurrence: Workshop Summary explores the complex web of molecular mechanisms that underlie the obesity-cancer link, the ways to design future studies to acquire the information needed to guide patient care, what to advise cancer patients about weight loss, diet, exercise, and other measures to reduce their risk of cancer progression or recurrence and policy suggestions related to research, education, and dissemination of the findings on obesity and cancer.
Author : Eric A. Klein Publisher : Springer Science & Business Media Page : 997 pages File Size : 54,5 Mb Release : 2004-05-07 Category : Medical ISBN : 9781592597765
Management of Prostate Cancer by Eric A. Klein Pdf
Although much progress has been made in the four years since the first edition of Management of Prostate Cancer, prostate cancer remains a significant biological, me- cal, and personal challenge for millions of men. In this interval, some important trends and observations have emerged that represent real progress in the field and which will shape the direction of clinical practice and research in the next 5–10 years. These obs- vations include: (1) a decline in prostate-related cancer mortality in the United States, likely owing to a combination of factors including screening, more aggressive and earlier therapy, and improvements in specific therapies; (2) a significant downward pathological stage migration, so that an individual’s chance of cure for a given stage, grade, and PSA is better now than it was early in the PSA era, even without associated improvements in individual therapies; (3) the recognition of new PSA isoforms that may refine screening strategies; (4) several randomized, phase III clinical trials demonstrating survival adv- tages of one form of therapy over another in selected populations (external beam rad- therapy with adjuvant hormones vs radiotherapy alone, radical prostatectomy vs observation); (5) a focus on the biology of bone and bone metastasis, and new agents that reduce skeletal-related events and which may inhibit the growth of new metastases; (6) second-generation anti-PSMA antibodies with improved potential for imaging and therapy; (7) the development and widespread adoption of nomograms that assist in cli- cal decision-making for individual patients; (8) the identification of new genes that
